| NPI | 1710129994 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEDINA DIANA DADURIAN Owner/President 201-791-4113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry |
| Additional Taxonomies | 1223P0221X Dentist, Pediatric Dentistry (Licence: NJ di 017957) |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2012-04-09 |